妇科腹腔镜手术前使用韩氏穴位神经刺激仪的临床观察

CLINICAL OBSERVATION OF USING HANS STIMULATING IN STRUMENT BEFORE GYNECOLOGICAL OPERATIONS BY LAPAROSCOPY

目的:观察术前韩氏穴位神经刺激仪(HNAS)对妇科腹腔镜手术病人血流动力学影响,术中辅助用药,术后苏醒及镇痛和不良反应的情况。方法:40例择期电视腹腔镜手术病人随机分成两组,实验组20例,术前应用HANS;对照组20例术前不用HANS。记录基础、切皮、气腹时、气腹后5min、放气、术毕各时点的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR),术中用药量,术毕、术后1,3,6h各时点的镇静评分,苏醒时间,镇痛时间及不良反应情况。结果:放气时DBP、HR实验组低于对照组,有统计学差异(P<0.01)。余血流动力学各指标变化不大。两组术后1h镇静评分明显低于术毕(P<0.01)。结论:HANS对腹腔镜手术病人有稳定血流动力学作用,对病人的苏醒、镇静、镇痛及不良反应无明显影响。

Objective: To observe the effects of using HANS stimulating instrument (HANS) before gynecological operations by laparoscopy on the patients' hemodynamics supplementary medication during the operation and the state awake. analgesia and adverse reaction of post- operation. Method: 40 cases of gynecological patients were randomly divided into two groups, freatment group (20 cases) giving HANS 30 min preoperation, and control group (20 cases) without HANS. SBP ,DBP, MAP, HR were recorded at the different time (including befort andstart-operation ,pneumoperitoneum and its producing 5 min later, deflation, and the end of operation, and the dose of the drugs, sedation scores, the times of awake and analgesia, and side effects occurred were also recorded. Results:DBP and HR of the treatment group were significantly lower than those of the control group at deflation time point (P<0.01). The other indexes of hemodynamics had little change. The sedation scores of operation 1hr later were significantly less than those of the end of operation for both groups (P<0.01). Conclusion: HANS has a stable effect on hemodynamics of the patients and has no significantly affection on awake, sedation, analgesia and side reactions of post-operation.